Racial Discrimination and Adverse Birth Outcomes: An Integrative Review.

The review included only English-language studies published in the United States from 2009 to 2015, so it may miss relevant work. The included studies used very different designs, sample sizes, sampling methods, and measures of racial discrimination, so the results cannot be combined into one clear estimate. Many studies used convenience samples, which limits how well the findings apply to other populations. Most studies defined race by self-report and did not distinguish subgroups such as black Caribbean women, so intragroup differences were not examined. Racial discrimination was mostly self-reported, and only one study used a biologic marker of stress, which may not fully capture actual exposure. Some studies did not test whether other factors, such as smoking or depressive symptoms, explained the associations. In one low birth weight study, birth outcomes were collected by self-report and the timing of data collection was not clear. Four included studies were qualitative, so they describe participants’ experiences rather than measuring how much discrimination affects birth outcomes.

The authors have no conflicts of interest to disclose.

Do not conclude that racial discrimination causes preterm birth or low birth weight. The review found mixed associations across observational studies, and the suggested care changes are expert recommendations, not tested interventions.